Uterine fibroids are the most common pelvic tumor. Fibroids may be seen as many as 1 in every 5 women in their childbearing years (the time after starting menstruation for the first time and before menopause.)

Fibroids usually affect women over age 30. They are rare in women under 20 or in those who have gone through menopause. They are more common in African-Americans than Caucasians.

The cause of uterine fibroid tumors is unknown. However, fibroid growth seems to depend on the hormone estrogen. As long as a woman with fibroids is menstruating, a fibroid will probably continue to grow, usually slowly.

Fibroids can be so tiny that you need a microscope to see them. However, they can also grow very large. They may fill the entire uterus, and may weigh several pounds. Although it is possible for just one fibroid to develop, usually there is more than one.

Sometimes, a fibroid hangs from a long stalk, which is attached to the outside of the uterus. This is called a pedunculated fibroid.

A pelvic examination may reveal an irregularly shaped, lumpy, or enlarged uterus. Frequently, this diagnosis is reliable. In some cases, diagnosis of fibroids is difficult, especially in obese women. Fibroid tumors have been mistaken for ovarian tumors, inflammation of the fallopian tubes, and pregnancy.

Some women may just need pelvic exams or ultrasounds every once in a while to monitor the fibroid's growth.

Treatment for fibroids may include:

Birth control pills (oral contraceptives) to help control heavy periods

Iron supplements to prevent anemia due to heavy periods

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naprosyn for cramps or pain with menstruation

Some women may need hormonal therapy (Depo Leuprolide injections) to shrink the fibroids. This medicine reduces the production of the hormones estrogen and progesterone. The hormones create a situation in the body that is very similar to menopause. Side effects can be severe and may include hot flashes, vaginal dryness, and loss of bone density. Hormone treatment may last several months. Fibroids will begin to grown as soon as treatment stops. In some cases, hormone therapy is used for a short period of time before surgery or when the woman is expected to reach menopause soon.

Surgery and procedures used to treat fibroids include:

Hysteroscopic resection of fibroids: This outpatient procedure may be needed for women with fibroids growing inside the uterine cavity. In this procedure, a small camera and instruments are inserted through the cervix into the uterus to remove the fibroid tumors.

Uterine artery embolization: This procedure stops the blood supply to the fibroid, causing it to die and shrink. The long-term effects of this procedure are still unknown, and the safety of pregnancy after this procedure is a concern.

Myomectomy: This surgery removes the fibroids. It is frequently the chosen treatment for women who want to have children, because it usually can preserve fertility. Another advantage of a myomectomy is that it controls pain or excessive bleeding that some women with uterine fibroids have. More fibroids can develop after myomectomy.

Hysterectomy: This invasive surgery may be an option if medicines do not work and other surgeries and procedures are not an option.

A pedunculated fibroid can become twisted and cause a kink in the blood vessels feeding the tumor. This type of fibroid may require surgery.

A fibroid sometimes blocks the fallopian tubes and prevents sperm from reaching and fertilizing eggs, which may cause fertility problems. In some cases, fibroids may prevent a fertilized egg from implanting in the uterine lining. However, proper treatment may restore fertility.

After a pregnancy develops, existing fibroids may grow due to the increased blood flow and estrogen levels. The fibroids usually return to their original size after the baby is delivered.

Most women are able to carry their babies to term, but some of them end up delivering prematurely because there is not enough room in the uterus.

Some pregnant women with fibroids may need acesarean section because fibroids can occasionally block the birth canal or cause the baby to be positioned wrong.

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